Aging at Altitude Fall 2023 by Prairie Mountain Media

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THROUGH THE GENERATIONS EXPO SATURDAY, OCTOBER 21 // DAILYCAMERA.COM/AGING MARKETING FEATURE

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Medicine Experts! Trust • Care • Excellence Feel Better. Move Better. Expect More.

Don’t miss Dr. Gronseth’s talk, “Moans, Groans and Creaky Bones: How to avoid and deal with the demons of joint pain” at the Fall Expo, Saturday Oct 21st.

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FALL EXPO

SAT., OCT. 21 • 8:30 A.M. TO 2 P.M. BOULDER JCC, 6007 OREG AVE., BOULDER (CORNER OF ARAPAHOE & CHERRYVALE)

FREE SEMINARS

Learn about aging programs, personal and ﬁnancial health, elder law, retirement planning and community resources. Visit with local experts and attend free educational seminars – and more!

AGING EXPO EXHIBITORS • • • • • • • • • • • • • • • • • • • • • •

Althaus Law, Colorado Estate Planning & Probate Amavi Integrative Mental Wellness Amira Choice Audio Information Network of Colorado Balfour Senior Living Boulder JCC Braverman Law Group, LLC Cadence Broomﬁeld by Cogir Cornerstone Orthopaedics & Sports Medicine Cultivate: Volunteer-Powered Services for Seniors Eye Care Center of Northern Colorado Fabulous Finds Upscale Consignments Family Hearing FirsTier Bank Flatirons Terrace, Dial Senior Living Frasier Gabe Bodner, The Bodner Team; One Trust Home Loans Greenwood & Myers Mortuary Hearing HealthCare Centers Helping Hands Consulting Hover Senior Living Community ICON Eyecare

• • • • • • • • • • • • • • • • • • • • • • • • • •

Intercambio Uniting Communities It’s Just Stuff Jorgensen Brownell & Pepin PC Kaiser Permanente Kapsak | Estes LLC Mary Hansen Matt Kollmorgen, Edward Jones Northern Colorado Rehabilitation Hospital Northern Colorado Long Term Acute Hospital OsteoStrong Renewal By Andersen Sky Health Services Sonoma Pharmaceuticals Spine West Physiatry & Sports Physicians Star Buds StretchLab Terry Chiropractic Vitality Studio The Brain and Behavior Clinic The Germany Law Firm The Natural Funeral The Pearl at Boulder Creek Trail Winds Hospice TRU Hospice Care/PACE University of Colorado Boulder Physiology Laboratory Vejrostek Tax & Financial YMCA of Northern Colorado

Bring your own snacks and beverages, food will not be provided.

LOBBY

LEVIN HALL

9:30 to 9:50 a.m. Benefits of Aging in a Community vs. Aging at Home presented by Cadence Broomﬁeld by Cogir

9 to 9:25 a.m. Moans, Groans and Creaky Bones: How to Avoid and Deal with the Demons of Joint Pain presented by Spine West

9:55 to 10:15 a.m. Reframing Aging, Transitioning from Decline to Rite of Passage presented by Frasier

9:30 to 9:55 a.m. Beyond Technology: Hear to a Higher Standard, presented by Family Hearing

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10 to 10:20 a.m. Special Needs Trusts, presented by Jeff Althaus, Althaus Law

10:45 to 11:05 a.m. Ecological Funeral Services: Green Burial, Water Cremation & Body Composting presented by The Natural Funeral

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10:20 to 10:40 a.m Taxing Times: Mastering the Trio of Estate-Related Taxes, presented by Diedre Braverman, Braverman Law Group

11:10 to 11:30 a.m. The Four Pillars of Retirement: Health, Family, Purpose and Finances, presented by Matt Kollmorgen, Edward Jones

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10:40 to 11 a.m. Estate Planning, Guardianships, Conservatorships presented by Susie Germany, The Germany Law Firm

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11 to 11:20 a.m. Fiduciary, Medical or Financial Agent: Roles, Responsibilities, Pitfalls Presented by Anne B. Jorgensen, managing shareholder, Jorgensen, Brownell & Pepin, P.C.

11:35 to 11:55 a.m. Learn More About Medicare Plans presented by Mary Hansen 12 to 12:20 p.m. How to Pay for Long-Term Care presented by Helping Hands Consulting

11:25 to 11:45 a.m. Food as Medicine presented by Sky Health Services

12:25 to 12:45 p.m. Reducing the Risk of Dementia: A review of the science and how to apply it presented by Amavi Health

11:50 a.m. to 12:30 p.m. Brain Waves: Innovations in Brain Health presented by Dr. Stephen Schmitz, The Brain and Behavior Clinic

12:50 to 1:10 p.m. Planning for Dementia & Alzheimer’s Disability presented by John Estes, partner, Kapsak | Estes LLC

12:35 to 1:10 p.m. Utilize Your Equity Strategically to Live a More Fruitful Life During Your Golden Years presented by Gabe Bodner, The Bodner Team: One Trust Home Loans

1:15 to 1:35 p.m. The Physiological Processes of Aging presented by the University of Colorado Boulder Physiology Laboratory

1:15 to 1:35 p.m. Engagement Strategies for Memory Care Residents presented by Drew Percival, executive director, Balfour Cherrywood Village Memory Care

1:40 to 2 p.m. What You Need to Know about Proposition HH, presented by Ron Vejrostek, Vejrostek Tax & Financial

ACTIVITIES/GIVEAWAYS •

Free Admission // Free & Additional Parking Overﬂow parking at Naropa University Nalanda Campus, 6287 Arapahoe Ave. A free shuttle will take you to and from the Naropa parking lot to the Boulder JCC.

10 to 11:20 a.m. LAW SESSION

10:20 to 10:40 a.m. Do You Need to Let Go of a Lifetime of Memories When Moving? presented by Beth Blacker, founder, It’s Just Stuff

•

Family Hearing, Free Redux Evaporation Treatment of your hearing aids. Find out how removing moisture leads to better sound quality from Family Hearing! Stretch Lab, complimentary demo stretches by trained Flexologists

•

Hearing HealthCare, Free Otoscopic Ear Exam

•

Free Event Bag from Kaiser Permanente, while supplies last

•

Stop by the Humana van for fun, games, and giveaways

FOR MORE INFORMATION, VISIT:

DAILYCAMERA.COM/AGING call 303.473.1420 or email jill@dailycamera.com

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University of Colorado Integrative Physiology of Aging Lab https://sealslaboratory.com/participate/

VOLUNTEERS NEEDED for Research Study!

Volunteers 50 years and over needed for a physiology study of the effects of Nicotinamide Riboside (NR), a form of vitamin B3. Must be willing to undergo 3 months of NR or placebo supplementation. Total duration of the study will require 16 hours over 4 months. All testing is performed on the University of Colorado Boulder main campus locations. There will be monetary compensation for your time.

Integrative Physiology of Aging Lab University of Colorado Boulder IPA Lab, 354 UCB Boulder, CO 80309

For more information, please email NRstudy@colorado.edu or call (303) 492-2485

PARTICIPANTS NEEDED FOR STUDIES INVESTIGATING THE POTENTIAL HEALTHY BENEFITS OF A NEW BREATHING EXERCISE INTERVENTION ON BLOOD PRESSURE AND CARDIOVASCULAR HEALTH

Participants Will Receive: PHYSICAL EXA XAM A BY PHYSICIAN

BLOOD PRESSURE SCREENING

COMPLETE BLOOD PANEL: BLOOD SUGAR & CHOLESTEROL

PHYSICAL FITNESS EVALUATION (HEART HEALTH)

BODY COMPOSITION (PERCENT BODY FAT) T))

BONE MINERAL DENSITY TYY (OSTEOPOROSIS RISK) K))

LOOKING FOR: Men & women (women must be post-menopausal) Ages 50+ years Higher blood pressure Willing to excercise up to 25 minutes per day, 6 days a week, for 3 months

You will also receive compensation for your time.

Integrative Physiology of Aging Lab at University of Colorado Boulder Main Campus Please email IMSTstudy@colorado.edu or call (303) 492-2485 for more information.

970-460-8970

To sign up, call or email us at the info listed on each flyer. For general info, visit: bit.ly/CUPhysio BOULDER DAILY CAMERA | LONGMONT TIMES-CALL

FALL 2023

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FALL 2023

HEALTHY AGING 8 Moans, Groans & Creaky Bones: How to avoid and deal with the demons of joint pain 11 Reducing the Risk of Dementia: A review of the science and how to apply it 14 Lifestyle Medicine: Improving the future of health care 16 Tips to Improve Your Hearing and Eye Sight Naturally 20 Sunscreen, Sunglasses a Start to Sun Protection 22 Falls and Fall Prevention SMART PLANNING 24 Senior Living Options, with Perks for Flourishing 28 Choosing Peace: Reframing aging as a rite of passage 30 Navigating Medicaid, Medicare 32 Advance Care Planning / Preplanning Your End-of-Life Celebration 34 Tough Questions Turn into Retirement Hurdles 36 Downsize Your Space, Maximize Your Life 38 How to Negotiate with Resistant Aging Parents? Borrow these tips from the business world

Trail Winds Hospice

ACTIVE LIVING 42 Staying Connected: How cultivating community, friendships and learning are just as vital as staying active 46 Improving the Quality of Life: Boulder County seniors have a myriad of resources to enrich their lives 48 Online Book Clubs: Conduits of social connection and literary enrichment CONTRIBUTING WRITERS Darian Armer, Linda Thorsen Bond, Emma Castleberry, Barbra Cohn, Adam Goldstein, Ben Haney, Sarah Huber, Julie Kailus, Gabrielle Kapsak, Ross Maak, Wendy McMillan, Pam Moore, Darren Thornberry, Shelley Widhalm Amy Harris Van Vranken SPECIAL SECTIONS DESIGNER/ COORDINATOR Greg Stone

303-442-5683 trailwindshospice.org 6

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MARKETING CONSULTANTS Julie Casper, Pete Christiansen, Ruth Garfield, Thais Hafer, Rich Hopkins, Jim Koppel, Keith Kratochvil, Abbie Lance, Billy Magrini, Robert Steinberg, Dale Sekuler ADVERTISING COORDINATOR Jeanine Fritz PUBLISHER Jill Stravolemos

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FALL 2023

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HEALTHY AGING

Moans, Groans

& Creaky Bones

How to avoid and deal with the demons of joint pain

By Pam Moore for Aging at Altitude

f you’re an older adult dealing with joint pain, you’re not alone. According to data from the 2022 University of Michigan National Poll on Healthy Aging, 70 percent of respondents, ages 50 to 80, reported currently experiencing joint pain. Creaky, uncomfortable and downright painful ankles, knees, hips, shoulders, wrists and fingers can interfere with everything from tying your shoelaces to hiking in the mountains. The good news

is, there is plenty you can do to prevent and treat joint pain. JOINT PAIN CAUSES Most of the time, joint pain in older adults is the result of inflammation, or swelling, caused by the loss of joint cartilage, says Dr. Robert Leland, MD, an orthopedic surgeon with Cornerstone Orthopedics/Orthopedic Centers of Colorado. According to Dr. Leland, there are a several reasons why you might have arthritis. “Arthritis can be caused by a variety of conditions

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including degenerative or inflammatory disease, it can occur following trauma such as a fall or a car accident, it may be due to sepsis, or it can be idiopathic, or the result of no known cause.” Hips and knees are the most likely to be affected by degenerative arthritis, (aka “wear and tear), or osteoarthritis, says Dr. Leland. Common risk factors for joint pain can include a sedentary lifestyle, certain medications, and the presence of autoimmune diseases, says Ryan Danyew, owner of OsteoStrong

Boulder. “Unfortunately, many causes of arthritis are unpreventable,” says Dr. Leland. “That being said, keeping weight at an optimal level, engaging in exercise including resistance training and core strengthening and flexibility training can be beneficial.” MANAGING JOINT PAIN Don’t wait to seek help until your pain becomes chronic, says Danyew. “Physical therapists are a great resource to help you identify the root of the problem and create a path forward to

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overcome it. OsteoStrong also offers a complimentary session to review your health goals and determine if their system can help you to overcome your joint pain.” Chiropractic care is another option to consider, says Technical Chiropractor Dr. Jamison Howe. “Regular chiropractic adjustments can help you prevent joint pain and treat it once it starts.” Meanwhile, do the best you can to stay active. That might mean walking instead of running but even a modified exercise program can go a long way. Dr. Howe suggests performing regular resistance training or weightbearing exercises. Dr. Leland agrees. “Bone density is improved with resistance training,” he says. Dense bones are healthy bones, and healthy bones can help keep joints pain-free. “If bone density levels are too low, fractures are more likely to occur. Appropriate prescription medicines

can be very helpful when indicated in improving bone density,” explains Dr. Leland. BUILDING BONE DENSITY While we know that resistance training is one of the most effective ways to build bone density, many of us are confused about the best way to go about it. “Based on the science of bone-building it is known that osteogenesis (the building of new bone tissue) requires more compression than is practically or safely attainable in daily life or at the gym,” says Danyew, who created OsteoStrong as a means of offering the aging population to have a safe means of naturally increasing their bone density. “As a company, we have worked with thousands of people and have successfully helped many increase their bone density, strengthen their muscles and joints and overcome many common age-related joint pain and discomfort,” he says.

Common risk factors for joint pain can include a sedentary lifestyle, certain medications, and the presence of autoimmune diseases.

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HEALTHY AGING

Reducing the Risk of Dementia A review of the science and how to apply it

By Barbra Cohn for Aging at Altitude

lmost 10% of U.S. adults over 65 have dementia, and another 22% have mild cognitive impairment. However, research is showing that if you treat early signs of mental decline, you may be able to slow

down and possibly reverse cognitive decline. Ilene Naomi Rusk, Ph.D., a neuropsychologist, functional brain health coach, and founder and director of The Healthy Brain Program at the Brain and Behavior Clinic in Boulder, strives to understand the root causes of a person’s

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psychological and brain health issues. She and a functional medicine team provide a neuropsychological diagnosis and treatment protocol for each patient, from brain training to nutrition. “It’s important to look at the whole person including lifestyle – stress resilience, mood, sleep, nutrition, exercise

– and assess a person’s vascular and metabolic risks,” she says. “We use the same cognitive training used in the FINGER study (Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability) and other studies which found that by targeting several lifestyle and

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HEALTHY AGING

physiological factors simultaneously you can reduce your risk of getting dementia. Those include having a healthy gut microbiome, eating more fruits and vegetables and sleeping well without sleep apnea. Physical activity is important because it increases brain-body communication, supports strength and coordination, helps circulation, clears toxins and improves oxygenation of your brain. “We need to be challenged every day,” Dr. Rusk adds. “Read new books, learn new crafts, and stretch ourselves so our brains create new neural connections. Social engagement is also one of the pillars shown to protect against dementia. Loneliness is a huge risk factor because it leads to depression and depression can shrink the hippocampus the same way Alzheimer’s does.” Dr. Elliot Good, DNP,

geriatric mental health specialist and owner of Amavi Integrative Mental Wellness is board-certified in psychiatric mental health and geriatric primary care. Amavi offers a multidisciplinary approach to diagnosing and treating memory disorders. Their team of professionals uses assessments, medications, and care coordination with other physicians to help patients manage their condition and maintain a high quality of life. Dr. Good emphasizes there’s no cookiecutter approach to help everyone. “A comprehensive plan may include medication, neurological assessment, or other interventions depending on a person’s risk factors,” she says. “First, we review primary prevention strategies to reduce dementia risk and optimize your well-being as you age, like exercise,

Ilene Naomi Rusk, PhD

Dr. Elliott Good, DNP

diet and sleep. We evaluate current medications and look for other things like sensory impairments or alcohol use that could impact cognitive function. Secondary prevention addresses existing issues that contribute to dementia such as hypertension and vascular changes in the brain, diabetes, vitamin deficiencies, depression, social isolation and anxiety. Then we work to get those things under control. “We have a

neuropsychologist who offers diagnostic assessments, as well as a cognitive rehab program. Research has shown the importance of cognitive stimulation as we age. For example, the ACTIVE Study done by the National Institute of Aging looked at the impact of structured exercises on memory, reasoning, and visual processing speed, which are the three areas that we start to lose in our 60s and can ultimately lead to loss of independence. The

Financial planning for dementia By Gabrielle Kapsak Kapsak | Estes LLC for Aging at Altitude

acing a diagnosis of dementia or Alzheimer’s is always a scary and sad prospect for you and your loved ones. However, there are a few legal steps you can take in conjunction with your family to ensure you are taken care of and your wishes are known. Speaking as soon as possible with a

reputable attorney from a firm experienced in elder law is an important first step. First, you should make sure that you have executed valid powers of attorney. This will include a durable general power of attorney, as well as a medical power of attorney. While it is important to get these done as soon as possible, it is equally important to give these decisions appropriate consideration. “Who you choose to act as your agent is

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crucial.” Recommends John Estes, a partner at Kapsak Estes LLC, a law firm specializing in Elder Law in Longmont. “It needs to be someone you trust implicitly, who you know without a doubt is going to put your interests and wishes first and foremost, and advocate for your needs and care even when there is pushback.” Second, you should make sure that your estate plan is finalized and distributes your estate in the manner that

you want before you lose the capacity to do so. Have a will in place that dictates who will receive your assets after you die, including any special provisions that may be necessary. “When planning for dementia or other potential cognitive issues, it is often advisable to establish a revocable trust to hold your assets, so that it’s easier for your trustee to handle your affairs during periods of temporary or permanent incapacity,”

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intervention group saw a significant improvement in their daily function and were far less likely to be in an at-fault auto accident in the following years,” says Dr. Good.

reduce cognitive decline. With small differences, they all emphasize eating vegetables, fruits, whole grains, fish, poultry, seeds, nuts and vegetables, and healthy fats, with reduced salt, sweets and red meats.

WHAT CAN YOU DO NOW? •

•

Get a ﬂu and pneumonia vaccine The research found that at least one flu vaccination led to a 17% reduction in Alzheimer’s. More frequent flu vaccination resulted in an additional 13% reduction in Alzheimer’s incidence. Vaccination against pneumonia between ages 65 and 75 reduced Alzheimer’s risk by up to 40%. Eat a whole foods diet Studies suggest that the Mediterranean, DASH, and MIND diets help

•

Drink coffee if you can tolerate it Coffee consumption over a lifetime reduces the risk of developing Alzheimer’s disease.

“We’re learning new approaches to improve cognitive health all the time,” says Dr. Rusk. “We want to help people stay engaged with their lives, their emotional and brain health, and to feel empowered to make positive lifestyle changes. Stay hopeful.”

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HEALTHY AGING

Lifestyle Medicine Improving the future of health care

By Amy Harris Van Vranken for Aging at Altitude

ccording to the American College of Lifestyle Medicine, an impressive over 80% of chronic illnesses can be addressed by a lifestyle medicine approach. What is lifestyle medicine? It’s an approach to health that’s based on six integrated pillars of healthy choices. Healthy choices in these six areas can prevent, manage and even reverse many chronic conditions According to Dr. Anne Giesen, founding

Dr. Anne Giesen, director, Sky Health Services in Boulder

director of Sky Health Services in Boulder, “Type 2 diabetes, high cholesterol, and high blood pressure

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are particularly responsive to lifestyle changes.” Lifestyle medicine can also improve quality of life, reduce health care costs and improve health disparities in communities. Many of Kaiser Permanente’s doctors are board-certified by the American College of Lifestyle Medicine. Kaiser notes, “Your prescription for better health may not be in a pill bottle. Even better? The pillars are interrelated – improving one favorably affects other aspects of your life.” Even as the

aging process causes certain physiological changes, lifestyle medicine promotes what’s called “healthspan” — the years spent in good health, without the chronic diseases or disabilities associated with aging. And of course, lifestyle medicine is backed by science and ongoing research. What are the six pillars of lifestyle medicine? The first is healthful eating through a diet that focuses on nutrientdense, fiber-rich foods like fruits, vegetables and whole grains. Evidence shows that plants strengthen our

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restorative sleep. This pillar immune system, decrease focuses on improving both inflammation in the body, the duration and the quality and improve brain health. of sleep. We know that good Avoiding sugary, fatty and processed foods is important sleep can improve our energy and mood. It also impacts too. Dr. Giesen adds, our heart health and insulin “Suboptimal diet is the #1 resistance. Good sleep preventable risk factor for even regulates your hunger death and disability in the hormones to help you world.” Exercise – the second pillar maintain a healthy weight. Social connection is – not only benefits your another important pillar of physical health by reducing your risk of health problems, lifestyle medicine. Spending positive time with others has strengthening your bones been proven to lead to longer and muscles, and helping life and better health — and you manage your weight, it makes you happier! Social it also improves your brain function. As you move more, connection can prevent heart disease you improve and stroke, your ability to “Type 2 diabetes, dementia and do the everyday high cholesterol, anxiety. It activities that also benefits are important to and high blood communities you, making life pressure are as a whole, easier and more particularly leading to a enjoyable. stronger sense Stress responsive to management lifestyle changes.” of belonging, trust and is important resilience. in lifestyle The last pillar of lifestyle medicine. It’s impossible medicine is avoiding risky to avoid all stress, but too substances such as tobacco, much negative stress can drugs and excessive alcohol. affect every organ in our All of these have been body. Effectively managing shown to increase the risk stress even improves of chronic conditions and the immune system. Try premature death. personalizing your stress Dr. Giesen: “Lifestyle management plan. Breathing medicine is a ‘root cause’ and meditation exercises approach to medicine. could be part of what works You could say it is ‘health’ for you. Or try listening to care rather than ‘sick’ care, music, watching a funny focusing on what someone movie, spending time can do with lifestyle changes in nature, or pursuing a to take control of their spiritual practice or creative health.” Lifestyle changes project. Taking breaks from can be difficult, but finding following the news or social resources and talking to your media can help you relax doctor about what’s right too. for you could make all the Even when life gets busy, difference. it’s crucial to take time for BOULDER DAILY CAMERA | LONGMONT TIMES-CALL

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Mental health is just as important as physical health. Get the care you deserve. Convenient locations in Niwot and Westminster, CO phone: 303.652.4196 www.AmaviMentalHealth.com FALL 2023

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Tips to Improve Your Hearing and Eye Sight Naturally turning to face you during conversations. It’s important to be active, and to be an advocate for yourself.” There have been major technology advancements beyond hearing technology in the field, Dr. Hearne said: “We adhere to a higher standard in hearing devices. A lot goes into the success of the patient, how we measure the output, the longevity, and how the device works throughout the patient’s lifetime.” She discussed three advances in hearing care:

By Linda Thorsen Bond for Aging at Altitude

s it possible to put hearing and vision loss on hold as we age? Maybe not completely, but there are some practical things we can do to slow the slide. For the Aging at Altitude Section and Expo, we sought experts in the field of hearing and vision and asked for their best advice. We’ve got some tips for you from Dr. Shawna Beasley, Hearing HealthCare Centers; Dr. Georgianna Hearne, Family Hearing; Dr. Diane Siegel, Eye Care Center of Northern Colorado and Dr. Eva Kim of Icon Eye Care. Audiologist Dr. Georgianna Hearne of Family Hearing

recommended wearing hearing protection around hazardous noise you might encounter in situations such as at concerts or when using power tools. “We need to protect what we do have,” Dr. Hearne said. “Prevention is so important, and it’s important to get checked and treated. A recent study of people with cardiovascular risk factors showed that treating hearing loss can help slow cognitive decline by 40% to 48%. We urge our patients to make the most of their hearing by wearing hearing aids if needed and reducing the noise in their environment. That’s as simple as turning the TV down, engaging in face-to-face communication, being social, having people reduce background noise or

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• Otoscan makes a 3D laser image of the ear for custom fitting a hearing device. The overall sound quality is improved depending on the hearing loss and reacting to factors such as background noise. It’s more comfortable, with better performance and fit for pretty much 98 percent of patients that utilize custom hearing aids and earmolds. • Redux is a hearing aid drier and dehumidifier. It removes 100 percent of the moisture in any hearing device. Moisture severely impacts the output of how well the device functions. Our ears are 70 percent humid. When patients come into the office we

Dr. Georgianna Hearne, Family Hearing

Dr. Shawna Beasley, Hearing HealthCare Centers

Dr. Diane Siegel, Eye Care Center of Northern Colorado

Dr. Eva Kim, Icon EyeCare

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use it throughout their treatment plan. • Hearing devices are a journey. When a patient is fitted with devices, that’s just the start of when they will be seeing us. We recommend appointments every 3 to 4 months for maintenance, an annual hearing test diagnostic measurement, with updates and evaluation of their devices to make sure they are working to the highest level of ability. We perform an electronic acoustic analysis on all hearing devices and test them to the limits to make sure they are performing up to manufacturer specifications. We want to help catch repair issues so patients don’t struggle if their devices need repair.” Dr. Shawna Beasley, Doctor of Audiology at Hearing HealthCare Centers, agrees about hearing protection in noisy environments and added: “The sooner you treat your hearing loss the better

for several reasons. First, research has shown that there is a significant link between hearing loss and cognitive decline. Hearing should be easy. It should be seamless, and it should just happen. It shouldn’t require a lot of effort and work. Those with hearing loss tend to feel that they are putting a lot more energy into following conversations. When extra effort goes into hearing, brain reorganization happens. You end up using different parts of your brain that are not meant for hearing which then takes away the primary function of that part of the brainit can no longer execute that function to its fullest capabilities because now it is helping you hear. For example vision – you end up relying heavily on visual cues such as lip reading and body language and that extra strain is put onto your visual cortex. I once had a patient tell me that she could see better now that she was hearing better! That’s because she no longer needed to rely on her visual cortex for hearing. Additionally, when that much energy is going into following a

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It’s as simple as being able to hear the difference between two very similar words such as sit and pit. If our brain hasn’t been stimulated properly, we have more trouble distinguishing words that sound similar. Hearing aids can stimulate your auditory nerves and provide better clarity and word recognition. The best thing you can do for your ear health, your brain, and your cognition is to treat your hearing loss as soon as possible.” Dr. Diane Siegel, a comprehensive ophthalmologist at the Eye Care Center of Northern Colorado, said that taking care of your systemic health is a critical part of taking care of your eyes and that full eye exams are important especially as you get older. “Having a healthy lifestyle, including healthy diet and regular physical activity and not smoking, will be beneficial for the health of your eyes. In addition, we recommend that adults have a baseline comprehensive eye exam by the time they turn 40. This is often when age-related eye changes often

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conversation, your brain has a hard time taking that conversation and storing it as a memory. You may have a conversation, let’s say in a restaurant where you are leaning in and focusing and straining to follow along, and a few hours later you may not recall how the conversation went or you may not remember that it happened at all. Research has shown a reversal in these cognitive issues as we appropriately treat hearing loss. Second, there is auditory deprivation which is what happens to your hearing system over time if you have hearing loss that goes untreated. Your auditory system is like a big muscle and it needs constant stimulation to maintain its strength. If you have hearing loss that isn’t being treated, even if it’s a high-frequency hearing loss, your nerves are not getting appropriate stimulation and can weaken and forget how to hear sounds. At that point, even if we try to turn things up, it has been so long since our brain has heard the information that it can’t make sense of it anymore.

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begin to occur. People who are 65 and older should get an eye exam every one to two years. Those with chronic conditions such as diabetes or high blood pressure or a family history of eye diseases may need to go earlier and more often.” “Other common-sense tips to protect your eyesight include protecting your eyes from UV light with sunglasses and hat while outside. In addition, I always recommend using protective eyewear to prevent injuries, particularly during higher risk activities, such as home repair, garden work and certain sports. If you have specific concerns about your eyes, I encourage you to make an appointment to evaluate your eyes carefully.” Eva Kim, MD and vice president of operations at Icon EyeCare offers these recommendations: We suggest that patients prioritize annual dilated eye exams with screening for diseases that occur as we age, such as macular degeneration, glaucoma, and retinal problems. Patients who are diabetic are required to see an ophthalmologist or optometrist, but others might not go to see anyone until their eyes are not good. We recommend preventative care with eyes just like with your body. A lot of people ask if they need eye vitamins. That’s not necessarily recommended for everyone if they have a balanced diet and take a daily multivitamin. The eye vitamins will be recommended if they have

macular degeneration which is not preventative. The vitamins won’t protect from macular degeneration but they may help keep severe dry macular degeneration so it won’t convert to wet macular degeneration. We recommend that as we age eyes get dryer across the board. Some people don’t have symptoms, but others experience blurry or teary eyes which is a sign of dry eyes. It may feel like a foreign body sensation, and it happens more issue in climates like Denver. Low humidity is difficult for people with dry eyes as they age. “If you live long enough, you will get a cataract, just like your hair turns white with age, and you get wrinkles. Cataracts are an accepted sign of aging. The internal lens of the eye is clear when we are young, but as we age there is a yellowing to it. It has cloudiness and gets harder and the size of the lens gets more rotund. That leads to higher pressure, which can affect our eye pressure and contribute to other problems. Our technology is the best it’s ever been. It should more generally be called lens replacement surgery because we take it out of the old lens and place it in a new lens. It’s so effective some people are even deciding to opt for lens replacement before they even need cataract surgery. Lens replacement, as opposed to Lasik surgery, is a cornealbased replacement.”

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FALL 2023

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HEALTHY AGING

Sunscreen, sunglasses a start to sun protection By Shelley Widhalm for Aging at Altitude

s soon as you’re born, you need to start caring for your skin not only to slow the aging process but to help prevent skin cancer. “There’s a lot of wrinkle prevention just by using sunscreen,” said Dr. Sarah M. Bair, dermatologist and owner of Crossroads

Dermatology in Longmont. “A lot of us wish we put sunscreen on our faces earlier on.” The primary cause of skin cancer is exposure to ultraviolet radiation from the sun, but there’s a genetic component as well, particularly with melanoma, the most serious form of skin cancer – the other two types are squamous cell and basal cell carcinoma. Melanoma

Dr. Sarah M. Bair, dermatologist, Crossroads Dermatology. (Photo: Flatirons Pro Media).

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“Fine lines, wrinkles, brown spots, those are all things that happen in the sun.” primarily develops in the cells that produce melanin but also can form in the eyes and inside the body. Risk factors for sun exposure include working outside, living in a sunny area like Colorado and having a fair skin type. The advice is to wear long sleeves and a broad-brimmed hat, avoid mid-day sun (the peak is 10 a.m. to 2 p.m.), and use sunscreen of SPF 30 or higher, reapplied every two hours. For the face, Bair recommends a mineral sunscreen, such as one that’s zinc-based, and reading labels, looking for the words “mineral” or “physical blocker.” A combined sunscreen and moisturizer keeps things simple, plus can help improve hydration and reduce fine lines and wrinkles. Sunglasses also help protect the delicate skin around the eyes and prevent eye conditions such as cataracts and macular degeneration. “Fine lines, wrinkles, brown spots, those are all things that happen in the sun,” Bair said. Bair recommends regular skin checkups, since “most skin cancers are very treatable if they’re caught early,” she said. Somebody with a history of cancer should be seen twice a year, while somebody

Sarah Bair, M.D.

with fair skin, lots of moles or a high cancer risk should come in once a year. The American Academy of Dermatology recommends annual checkups, and older adults living in Colorado especially need to keep up with that pace, Bair said. A checkup involves using a dermatoscope magnifying device to visually inspect the skin for new growths like moles or lumps or changes to old growths, starting with the scalp and focusing on the back, arms, legs and face. To undo damage to the skin, Bair recommends applying a retinol or retinoid that increases skin turnover and improves tone, texture and pore size. “Vitamin C serums and topical antioxidants will help with the cosmetic appearance of skin to help improve that damage that’s been done by the UV light,” Bair said.

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FALL 2023

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HEALTHY AGING

Falls and Fall Prevention By Amy Harris Van Vranken for Aging at Altitude

lthough falls can happen at any age, one in four Americans over the age of 65 falls each year. Falling can be fatal for older adults. According to Dr. Cliff Gronseth at Spine West, falling is one of the leading causes of death in people over age of 65. “Almost 80% of deaths from falls in the elderly are from head injuries and hip fractures,” adds Dr. Gronseth, “and these injuries are oftentimes preventable.” Even when an injury isn’t fatal, it often leads to a long-

Dr. Gronseth recommends a fall risk evaluation at age 65 or 70 to create a personalized home program to maintain function and avoid future injury. (Photo courtesy: Spine West).

term loss of independence, social isolation, and

increased fragility. But falling doesn’t have to be a normal

part of aging. Taking action now can help you stay active and independent for years to come. Fall prevention starts with some simple daily habits that can maintain orthopedic health. Maintain a healthy diet, paying special attention to calcium and vitamin D to help build strong bones that resist fractures. Instead of trying to completely overhaul your diet overnight or relying on supplements that can sometimes do more harm than good, it can be more effective to work on gradually adding nutritious foods to your daily meals. If you aren’t sure where to

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start, ask your doctor or a dietician. Talk to your doctor about starting an exercise routine if you don’t already have one. Inactivity leads to a decrease in strength and balance as well as bone loss. Find a routine that works for you! Stretching and warming up are more important now, and weight-bearing exercise builds bone mass. Even if you already have some orthopedic problems, walking, swimming and biking can still be possible. Work on developing balance, strength and flexibility through exercises like yoga or Pilates. Think about your fashion choices. Dress comfortably, but avoid baggy clothing that can catch on your surroundings. Choose

supportive shoes that fit well and have non-slip soles. Don’t walk around in your socks, and avoid high heels – they can throw off your balance and increase your risk of back and knee pain. Your doctor is an important partner in helping you maintain orthopedic health and prevent falls. Get a yearly checkup and ask a qualified doctor about your personal fall risk. At Spine West, you can consult a doctor in physiatry, a medical specialty that has expertise in bone, muscle and nerve health with a focus on the whole person. Dr. Gronseth recommends a fall risk evaluation at age 65 or 70 to create a personalized home program to maintain function and avoid future

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injury. Also, consider bone density testing, especially if you’ve already experienced a fracture. Carefully follow all instructions for your prescribed medications and be aware of side effects such as drowsiness or impaired balance. Even your vision and hearing can seriously affect your fall risk, so be sure to have those checked annually and keep your glasses and hearing aids up to date. Finally, be aware that nicotine decreases bone health; alcohol and other substances such as marijuana impair judgment and coordination. Most falls happen at home, but many older adults have lived in their homes for years without considering simple changes that could

make their environment safer. Here are a few key changes to make. Remove tripping hazards such as clutter, electrical cords and loose rugs. Increase lighting in stairs and hallways and add night lights on the way to the bathroom. Keep a flashlight next to your bed for power outages. Consider living on one level, or make sure stairs are safe and have handrails on both sides. Install grab bars in the shower/bath and near the toilet. When you’re home, take care not to change positions too quickly. Something as simple as pausing when standing up or heading up or downstairs can make all the difference.

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SMART PLANNING

Senior Living Options, with Perks for Flourishing By Sarah Huber for Aging at Altitude

(Photo: Hover Senior Living).

he ideal senior living option is where you or your loved one will flourish. And for many, flourishing in the senior years happens best in a senior living community, where new friendships thrive and residents need not worry about home maintenance or whether their future healthcare needs will be met, said Michelle Newitt, director of sales at Amira

Choice Arvada, which is scheduled to open in April. Carrie Gray, vice president of sales and marketing at Balfour Senior Living, agreed. “In a community setting, residents are free to focus on what they want to do that day,” she said. “They don’t need to think about car insurance, taking care of a home or even how they’re going to get to activities.” She continued, “We sometimes see what we’ve called a ‘glow up’ when residents move in. They’re

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typically eating better, they’re exercising and thus stimulating themselves physically, so they’re also sleeping better.” Scott Adams, marketing and communications coordinator at Balfour Senior Living, which has locations in Louisville and Longmont, added, “The menu is delicious and nutritious and meets an array of dietary needs.” Vickie Stotler-Smith, executive director of Flatirons Terrace in Boulder, emphasized the importance of daily social connections. “Being in a community of people who interact with you and genuinely care about you can add years to your life. Our residents develop true connections, friendships, and support systems, pursue new hobbies and discover new interests – they experience true growth. Increasing social interaction keeps the mind sharp, improves cognitive health and lowers the risk of dementia.”

It many communities, senior care living options include independent living, assisted living, skilled nursing support, memory care and for short-term needs, respite care. While Balfour campuses are integrated, meaning residents from every spectrum of “the Balfour continuum of care” gather for meals and special events, other communities have more distinct living arrangements. Still others, like Amira Choice, offer the convenience of staying in the same apartment if a transition from independent living into assisted services is needed, Newitt said. Senior living communities feature a variety of amenities and enrichments for all levels of care. Adams said a few residents at Balfour continue to pursue a career, while most are happy to spend their days strolling the gardens, working out in the fitness center, attending lectures, playing games with fellow residents, visiting family, hiking, shopping and

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(Photo: Hover Senior Living).

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frequenting local museum and music venues. At Flatirons Terrace and The Pearl at Boulder Creek, both located near the University of Colorado Boulder campus, residents flock to CU faculty concerts and festivals on the Pearl Street Mall. Also at both,

residents enjoy meals prepared by an executive chef in their on-campus restaurants. Speaking of food, holidays and birthdays are a big deal at The Pearl, said Christian Shahmardian, senior living advisor. “All holidays are celebrated at our community for all

(Photo: Flatirons Terrace).

religions and open to the family and guests of the residents,” he said. Pearl residents anticipate weekly live musical performances, and several residents have discovered their inner artist through the Pearl’s resident-taught art classes. Flatirons Terrace gets

residents moving with escape rooms, miniature golf and bowling, as well as regular trips to the farmers’ market, library and recreation center and outings to Rocky Mountain National Park, Black Hawk and the Denver Center for Performing Arts. Hover Senior Community,

(Photo: The Pearl at Boulder Creek).

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a nonprofit with a legacy of 43 years in Longmont, makes an effort to involve the entire community in on-campus events, including their annual Concert at Hover, Octoberfest and “Eight Over 80” ceremony, said Lisa Bryant, Hover campus community relations director. In November,

Hover offers a holiday photo event, “creating lasting memories,” she said. “Hover Senior Living gives back to the surrounding community with services that engage our residents in making a difference throughout the city. We know that it is important to make a difference in the lives of

(Photo: Amira Choice Arvada).

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many, and we do this yearround.” Academy Boulder has put a premium on wellness, in addition to enrichments and amenities. The Vitality Center at the Academy’s newest Mapleton Hill campus will “offer hot/cold plunge pools, rehabilitation services and wellness programs meticulously crafted to aid individuals in their journey towards rekindling an active lifestyle,” said Jackie Schaible, Academy marketing director. Schaible said that the “awe-inspiring mountain vistas” and farmto-table cuisine integral to the Academy give residents what they love about the “Boulder way of living” at any age.

Finally, Felicity Ferguson, executive director of Cadence Broomfield by Cogir, noted that one of the most important benefits of a senior living community is, overall wellness, safety and security. In a senior community, “safety is builtin,” she said, from grab bars, non-slip flooring, emergency call pendants and walk- and roll-in showers. Security at Cadence Broomfield includes ID-required access doors, security cameras and a “24/7 awake staff who can respond to your needs,” she said. Nursing and caregiving support are likewise available around the clock, vitals are taken monthly as a preventative measure and practitioners see residents on at least a monthly basis.

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FALL 2023

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SMART PLANNING

Choosing Peace Reframing Aging as a Rite of Passage

By Wendy McMillan for Aging at Altitude

ver-the-hill, decrepit, cranky, and past it – these and many more flippant descriptions attempt to dismiss and make light of the uncomfortable truth that we are all inevitably aging. At least, that’s the goal. Where then are the words that honor age, and the wisdom and contemplative stillness that it can bring? It’s time to change the narrative and alongside it the mindset. From anti-wrinkle creams

to super-boosting serums, everywhere we turn there are messages to fight time. But journeying through life shouldn’t be a battle, says Cheryl Swing, Director of Spiritual Life at Frasier, a lifeplan community in Boulder offering a continuum of care. Aging carries vulnerability and fear, without a doubt. That doesn’t mean it’s negative. “Language is so important,” Swing says. “It’s a symbol of culture and identity, the way we communicate. We have language that celebrates all

stages as a rite of passage — for bar mitzvahs, marriages, having children… up to retirement. Post-retirement, we are kind of illiterate. If something is unnamed, chances are it’s also unserved.” At Frasier, Swing and her team provide emotional and spiritual support and resources for residents, their families, friends, and staff, as well as all the vendors and collaborators the community welcomes. There are traditional, pastoral services, some of which Swing leads, for a broad spectrum

of religions, as well as a multitude of opportunities to explore spirituality and the human condition in secular ways, including book clubs, film and discussion groups, and a variety of enrichment programs. Through all of these, Swing sees the ways confronting the reality of our impermanence connects us all profoundly. “It is part of the human condition to always be in transition, and eventually we are all confronted with our mortality,” Swing says. “Life can take on a more melancholy tone,

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as grief accompanying loss compounds. But, this too can be temporary. It truly is a rite of passage to leave things behind, to become contemplative as we move forward.” In supporting her community, Swing has drawn up a series of spiritual tasks that promote a more peaceful approach to aging. Top on the list is learning to let go, not just of material things, but also the hurts and expectations we hold, the resentments and regrets. She encourages making time for solitude — not to be confused with isolation. “Isolation is when we’re cut off from connection,” Swing says. “Solitude is something we choose, a space reserved for looking inward, peace, and stillness.” Of course, reframing is not as simple as switching up words. It takes consistent work, and there will be some discomfort and disruption. “Leaning into the hard stuff – authenticity, vulnerability – this makes us who we are,” Swing says. “Modeling vulnerability is an essential part of who I am and how I can reach and support others.” Trust, that the effort is worthwhile. There will also be peace and healing. “It’s a whole new opportunity for wonder and renewed curiosity,” Swing says. “Let’s dislodge the old metaphors and embrace what is sacred, and universal.” Cheryl will be speaking on this subject, A Rite of Passage: Reframing How We See Aging, at the Aging at Altitude Expo at 9:55 a.m. on October 21. BOULDER DAILY CAMERA | LONGMONT TIMES-CALL

Cheryl Swing, Director of Spiritual Life at Frasier FALL 2023

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SMART PLANNING

Navigating Medicaid, Medicare and Long-Term Care By Darian Armer for Aging at Altitude

hen it comes to navigating Medicaid, Medicare, and long-term health care it can be a daunting process. That’s why many people turn to consultants and insurance brokers to help make sure they get the exact coverage they need.

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MEDICAID “We help individuals apply for long-term care Medicaid, which is the highest level you can ask the government for. It can be difficult to get and difficult to go through that process alone,” says Mary Doerr, Director of Community Affairs and Eligibility Consultant for Helping Hands Consulting. Doerr says Helping Hands helps people figure out if there are any hurdles to obtaining long-term care Medicaid and how to overcome them if so. “Long-term care can mean I need some assistance in my house ranging from light cleaning to handling my medications. I may need someone to prepare meals for me or help me bathe. You must meet the criteria functionally and under activities of daily living. The exception is if someone has some sort of brain injury, mental illness or mental cognition disease like Alzheimer’s,” she says.

A person must qualify income and asset-wise to qualify for long-term care. Doerr says long-term care is for an individual who does not expect to get better. They are at their worst or progressively getting worse. It’s important to note longterm care is not hospice. A person could be on longterm care Medicaid for 10 years or more, they just need to apply and be approved annually. Long-term Medicaid will cover any expenses you incur medically but will not cover room and board at an assisted living facility, which Doerr says can cost up to $9,186 per month per person. Something most people won’t be able to afford. In that case, Medicare can help cover the cost if a person is eligible. “We’re outliving our money and our retirements,” she says. “That’s why you plan and hire a professional like Helping Hands Consulting. We can inform, educate, and discuss rules and regulations. We’re always here to help. We have a 99 percent approval rating for applications we submit. Because all of us are consultants we know the rules and regulations inside and out.” MEDICARE LeSean Wittkop of Wittkop Insurance gave us a rundown on the different parts of

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Medicare and what they cover. She says there are two parts to the original Medicare. Medicare Part A and Medicare Part B. There’s no fee for Part A if someone has worked and paid taxes for 40 years. This also applies to someone like a stay-at-home mom who had a spouse who worked and paid taxes 40 quarters. Part A is hospital coverage. Part B is insurance for everything else that’s not inpatient treatment. “Think doctor’s visits. Everyone who’s on Medicare has to pay a Part B premium unless they have assistance like Medicaid,” says Wittkop. “The base level premium for 2023 starts at $164.90 a month. What you

pay in premiums is based on your income reported in your taxes.” Medicare pays 80 percent of medical bills, and 20 percent must be covered by the subscriber. That’s where Wittkop says a couple of options come in. A person can choose to go with a Medicare Supplement Plan, also known as Part C of Medicare. In this scenario, you pay a monthly premium based on which plan and level of coverage you get. It’s also known as a Medi-gap plan because it covers the 20 percent gap you must pay after Medicare pays 80 percent. With Part C you must also have a standalone prescription drug plan, or you can be penalized each month.

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The second option is to go with a Medicare Advantage Plan. It combines Part A, Part B and sometimes D. “With Advantage Plans a lot of them don’t have premiums, but you are paying a copay. At the ER, hospital, or skilled nursing facility you’re paying copays. All Advantage Plans have a Maximum Out of Pocket.” Wittkop says it depends on your lifestyle when it comes to which plan she recommends to go with. “The Advantage Plan is cheaper because you’re only paying when you have to use it. You’re not paying monthly. Also, a lot of Advantage Plans have extras like vision, hearing, chiropractor plans, Silver Sneakers and more. The

drawback is you don’t have any out-of-network coverage,” she says. “For people who have a lot more health issues and think they’ll hit their maximum with an Advantage Plan if it’s a Medicare-approved service, then the supplement plan will pick up 20 percent. For them, Supplement is what I would recommend. I want to emphasize that option 1 and option 2 are case by case. At minimum, if you don’t think you want to do a supplement or advantage plan, get a prescription plan to avoid paying a penalty,” she says. “It’s important to work with a broker and get that personalized attention and customized service at no cost to you.”

FALL 2023

| AGINGATALTITUDE

SMART PLANNING

Advance Care Planning/Preplanning Your End-Of-Life Celebration By Darren Thornberry for Aging at Altitude

t’s not always easy to have conversations about the end of one’s life. However, planning well for the inevitable is perhaps one of the greatest gifts a person can give to their families, and it helps loved ones to carry out the exact final wishes of a family member. “Preplanning your end-oflife celebration is a beautiful and considerate way to ease the burden on your family while ensuring that your

final farewell truly represents your unique journey,” says Seth Viddal, co-owner of The Natural Funeral. “Remember that your end-of-life celebration is a reflection of your life’s journey. Embrace the opportunity to celebrate your legacy, your impact on others, and the love you’ve shared.” If it feels overwhelming to get everything in order for your own celebration, perhaps turn the tasks into a simple checklist while you have time to think deeply about them. The Natural

Funeral suggests that you start early, communicate your wishes, choose a theme or style, select a location, create a guest list, plan meaningful rituals, write

your story, and consider the budget for the celebration. The administration of the celebration of life is left to the loved ones of the deceased, and they’ll

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SMART PLANNING

want to ensure that the event reflects their loved one’s passions. Those passions may also extend to environmentally friendly practices including green burial, water cremation and body composting. So an individual planning for the end of life should be explicit about their wishes. “There are definitely people that want a more natural/green burial or composting or water cremation,” says Cara Leisher, RN and Clinical Director of Trail Winds Hospice. “In those cases, we refer them to mortuaries that provide those services. I would say most people still prefer fire cremation but we do see more and more people wanting more natural

services due to the negative effect that the older methods have on our planet. We see this, especially in the Boulder area.” The team at Trail Winds Hospice (trailwindshospice. com) speaks with a patient and their family to find out if they have a mortuary picked out already. If not, they find out what type of funeral home matches their needs best (cremation, cost, body donation, more “natural” funeral needs) and they “star” the mortuaries on the list that match their needs. “Ultimately, the choice among these options should reflect personal values, beliefs, and environmental considerations,” says Viddal. “Our recommendation is to explore these options with

an open heart and in-depth discussions with loved ones. Additionally, it’s essential to consider local regulations and the availability of these methods in your area.” Here are some environmentally friendly options: Green Burial: Many people are drawn to the idea of returning their bodies to the earth in a biodegradable casket or shroud. Green burial is often recommended for those who have a strong connection to nature and wish to minimize their environmental impact. It allows for a peaceful and harmonious return to the earth, promoting the conservation of natural landscapes. Water Cremation:

This is an eco-friendly alternative to traditional cremation. Alkaline hydrolysis is placing the body in a warm bath along with alkaline chemicals that aid in transforming the body into a nutrient-rich liquid that is neutralized. The skeletal remains are dried and processed into powder, which is returned to the family. Water cremation does not involve the combustion of fossil fuels. Body Composting: This is an innovative and sustainable approach to handling human remains. Body composting uses organic material to accelerate the natural transformation of the body into a rich, nutrient soil. This process takes 2 to 4 months.

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Tough Questions Turn into Retirement Hurdles

By Ross Maak for Aging at Altitude

hen it comes to retirement, most of us face some daunting, important questions. When can I afford to retire? How much money is enough? What about health care? How can my family help? What happens when the economy shifts, taxes go up or benefits go down? In an uncertain fiscal climate, it’s difficult to get straightforward answers because everything is shifting. WHO CAN HELP? Many of us have family members or even close friends who are willing and able to help. They can do so in several different ways, according to Anne

B. Jorgensen, managing shareholder with Jorgensen, Brownell & Pepin. First, a fiduciary is a person or organization that “owes to another the duties of good faith and trust,” Jorgensen said. “The highest legal duty of one party to another, a fiduciary must act in the other party’s best interest. A medical power of attorney, financial power of attorney, guardian and conservator are all fiduciaries.” Medical power of attorneys is there to make decisions based on your wishes, if known, and choices in your best interest. The financial power of attorneys is similar, stepping in to handle paying bills, preparing necessary accounting issues, administering assets and

AGINGATALTITUDE | FALL 2023

handling financial issues, Jorgensen said. Guardians and conservators are courtappointed roles that replace the medical and financial power of attorneys, respectively, if necessary. For a retiree, finding the right person or organization is key. Jorgensen shared some of the assets to look for while considering who you want in the above roles. Tops is finding someone to pay particular attention to detail. They should learn all they can about the role and what powers and limitations they have. Also, they should keep receipts and any relevant time records. Finally, Jorgensen said it’s important for helpers to always keep finances separate. “Do not comingle your assets with those of the principal,” she said. MEDICARE Getting coverage is pretty much the same as it’s been in the past. That said, Ron Vejrostek at Vejrostek Tax & Financial did have one valuable piece of advance moving forward. “Do not deal with the phone centers,” Vejrostek said in an email. “Using local agents doesn’t cost you a penny more and you get someone who knows the local market, networks, etc., and who will sit down with you and make sure you have

the best plan available for your particular needs.” Reaching a local agent isn’t as easy as it sounds. Most internet searches lead to phone centers. Vejrostek, who is a local agent, recommended medicaresupp.org as the best choice to find a local agent. He also said medicareagentshub.com does have local agents as well, but may give you agents licensed in your state that may not be local. Vejrostek added that going to free expos and fairs or seeking out publications geared toward seniors can also be valuable resources for finding local agents. As for Medicare itself, Vejrostek did say there are some new plans out this year offering more and better dental benefits and that many companies change how much they charge for prescription medicine annually. “So you may want to make sure all your prescriptions are still covered at reasonable rates,” Vejrostek said. “It pays off to review (everything) on an annual basis. You can’t do that at a call center, but you most certainly can with a local agent. “Not to mention you will also have someone there in your corner to help out when things don’t go according to plan … which sometimes happens.”

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SMART PLANNING

Downsize Your Space, Maximize Your Life By Emma Castleberry for Aging at Altitude

s we get older, we often find ourselves needing to simplify. We want a smaller space, less maintenance hassle, and less stuff to worry about. Sometimes, this prospect can seem daunting or even negative, but it doesn’t have to be. In fact, taking a more minimalist approach will likely leave you happier and more fulfilled because you have more time for the things that matter. Here are some tips for preparing for this new phase of life and enjoying it.

RIGHT-SIZING: REDEFINING THIS NEW CHAPTER “Downsizing is such an impersonal term,” says Jessica Champlin, chief revenue officer at Boulder Creek Neighborhoods. “It kind of assumes that anyone seeking a new way of living just needs to have less space.” At Boulder Creek Neighborhoods, they prefer the term “right-sizing” instead. “Right-sizing into a home that meets your needs for now and into the future means that your home is a way to support your lifestyle dreams instead of being

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a burden to them,” says Champlin. As people enter different phases of life, including seniority, they need a home that supports their different needs. “That may mean less square footage,” she says, “but it often means so much more: folks seeking main floor living, wanting space for hobbies instead of space for small children, needing floor plans that work with their way of living, regardless of size. It’s really not about having less square feet, it’s about having the right spaces that work for them.”

LET GO OF THE STUFF “Having too much external clutter will only create more internal clutter in our lives,” says Beth Blacker, chief of Chaos to Calm at It’s Just Stuff. Decluttering and getting organized is a crucial part of senior years, but it isn’t always an easy one. The process of sorting through a lifetime of accumulated goods will likely be an overwhelming one, so don’t try to do it in a rush. “Give yourself time,” says Blacker. Also, take a relaxed approach when sorting through your belongings. Often, while decluttering, we will come across sentimental

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gifts that inspire a sense of obligation. “Let go of any guilt you are feeling about giving away anything that someone gave you but you truly have no use for moving forward,” says Blacker. “There are always people that need things and we do our best to get anything a client wants to donate directly to people in our community before considering dropping anything off at a donation center.”

rising, that allows senior homeowners to access more and more of their equity over time with a HECM.” Another popular option is a reverse mortgage, which allows seniors to access some of the equity in their home without incurring a monthly mortgage payment and without needing to sell the home to access the equity. “The reverse mortgage improves both monthly cash flow by eliminating the need to make a mortgage payment and it allows the homeowner to pull cash out of their home,” says Bodner. “By accessing some of the equity in their home, they can avoid spending other assets that might have tax implications. So, using a reverse mortgage not only improves a senior’s cash and cash flow, but it can also improve seniors’ overall financial and tax situation.”

SAVE MONEY WITH RESOURCES DESIGNED SPECIFICALLY FOR SENIORS When it comes to the financials of this new chapter, there are a variety of unique mortgage opportunities available to seniors. Gabe Bodner, retirement mortgage planner at One Trust Home Loans, says that the best of those right now is a home equity conversion mortgage (HECM). “This program offers a tremendous amount of flexibility that most other mortgages simply do not offer,” he says. “For example, the HECM offers a line of credit which grows at the interest rate plus .5 percent. With interest rates

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SMART PLANNING

How to Negotiate with Resistant Aging Parents? Borrow These Tips From the Business World By Kaiser Health News

ou’ve reached a standstill with your mother and father, who are in their late 80s. You think they need some help in the home, but they vigorously refuse. You’re frustrated because you want to make their lives easier. They’re angry because they think you’re interfering in their affairs. Can negotiation and disputeresolution techniques

used in the business world help defuse these kinds of conflicts? Yes, say a group of researchers at Northwestern University. And they’re on to something. These experts have developed a training curriculum on negotiation and dispute resolution for social workers, care managers, and healthcare professionals who regularly work with resistant older adults. Materials for family caregivers are being developed, too. Instead of

avoiding difficult issues or simply telling people what to do (“You’ll need home health aides several times a week for the foreseeable future”), professionals learn to elicit what’s most important to older adults and approach arranging care as a collaboration, not an edict from on high.“People get into so many arguments when they get older. It’s something I see every day in my work,” said Lee Lindquist, chief of geriatrics

at Northwestern University’s Feinberg School of Medicine, who’s leading the project. Its goal is to de-escalate conflicts and make it easier for older people to receive needed support, she said. In May, Lindquist and her team planned to launch another part of the project: a trial of a computerbased training program for family caregivers of people with mild cognitive impairment or early-stage dementia. The program,

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called NegotiAge, features avatars of older adults and allows caregivers to practice negotiation techniques under different scenarios.“You get thrown different situations, different emotions, and you get to play the game of negotiation as often as you want,” Lindquist said. Nearly $4 million in funding for the project comes from the National Institutes of Health. After evaluating the program’s effectiveness, Lindquist hopes to make NegotiAge widely available. In the meantime, there are several steps family caregivers can take to forestall or resolve conflicts with older parents. PREPARE Preparation is essential for any type of negotiation, advised Jeanne Brett, professor emerita of dispute resolution and organizations at Northwestern’s Kellogg School of Management and a member of the NegotiAge team. “You want to think through answers to several fundamental questions: What issues need to be addressed? Who are the parties invested in these issues? What are the parties’ positions on each of these issues? Why do you believe they’re taking those positions? And what’s going to happen if we can’t reach an agreement?” It’s helpful to write down answers to these questions in a planning document. Be sure to include yourself among the parties and spell out your goals for the conversations to come. What might this look like in practice? Let’s say you want your father, who’s in

Negotiations have the best chance of success when they address the interests of all the parties involved.

his early 90s, to stop driving, because he’s started getting lost and his vision isn’t great. The people with a stake in the discussion include your father, your elderly mother, you, your two siblings, and your father’s physician. Your mom may be concerned about your father’s safety but hesitant to raise the issue for fear of provoking an argument. One of your siblings may agree it’s time to take away the car keys, while the other may think Dad is still fine on the road. The doctor may recommend a driving evaluation and subsequently offer his professional opinion. LOOK FOR COMMON INTERESTS Your job is to find areas where these parties’ interests intersect and work from there. Everyone wants your

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father to remain active and see his friends on a regular basis. Everyone wants to ensure he doesn’t injure himself or anyone else on the road. Everyone wants to respect his desire for independence. No one wants to label him incompetent. Brett distinguishes between positions, such as “I’m not going to stop driving,” and interests, or the reasons why someone takes a position. In this case, Dad may be afraid of becoming isolated, losing autonomy, or giving up control over his affairs. But he, too, may worry about hurting somebody else unintentionally. Negotiations have the best chance of success when they address the interests of all the parties involved, Brett noted. Don’t adopt an adversarial approach. Rather, emphasize that you’re on the

same team. The goal isn’t for one side to win; it’s for people to work together to find a solution to the issue at hand. ASK QUESTIONS Don’t assume you know why your parent is taking a certain position (“I don’t want to go to the doctor”). Instead, ask follow-up questions, such as “Why?” or “Why not?” If an older person snaps, “I don’t want to talk about it,” don’t back away. Acknowledge their discomfort by saying, “I understand this is difficult,” while adding, “I care about you and I want to know more.” Lindquist favors starting difficult discussions with patients with open-ended questions: “What are some things you’re having issues

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| AGINGATALTITUDE

with? What are you doing that you wish you could be doing differently? What would make your life easier?” Listening carefully and making the person you’re negotiating with feel heard and respected is essential. If one of Lindquist’s patients tells her, “I make my own choices, and this is what I want,” she might respond, “I agree you’re the boss, but we’re both here to make your life better, and I’m worried about you.” BRAINSTORM STRATEGIES Negotiations with family members are often charged with emotions that can easily spiral out of control. But don’t reciprocate if someone

gets angry and lashes out. “When you’re buying a car, if you can’t agree with the dealer you’re talking to, you can go to another dealer. When you’re in a conflict with a family member, you don’t have this option. You’ve got more stubbornness and more defensiveness about disabilities,” Brett said, “and preserving relationships is even more important.” Redirect your focus to brainstorming strategies that can help solve the problem at hand. Get creative and put lots of options on the table. Invite your parent to respond and ask “Why?” or “Why not?” again as needed. If you find yourself going round and round without making progress,

wanted to resume driving in 2021 after recovering from a serious fall. Brett and the couple’s daughter couldn’t convince him this might be risky, but the older man, then 89, agreed to get a driving evaluation at a facility associated with a Chicago hospital. When they recommended he stop driving, he gave up the car keys. Brett later hired a neighbor in the small town in France where they now live to ferry her husband to appointments several times a week. Twice a week, she drives him to a nearby village where he has coffee with friends. He gets out into the world and she doesn’t worry about safety — an outcome both can live with.

try saying something like, “We could argue about this all afternoon, but neither one of us is going to give in. Let’s set aside our arguments and come up with five ways that you can get to activities without your car,” Brett said. Don’t expect to agree on a strategy right away. “You can say, ‘Let’s bring in Mom and talk about this later,’ or, ‘Let’s think about this and check in with each other next week,’” Lindquist suggested, noting that many negotiations take time and can’t be rushed. BRING IN A THIRD PARTY If all else fails, appeal to a third party. This was Brett’s strategy when her husband, who has Parkinson’s disease and compromised vision,

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Staying Connected How cultivating community, friendships and learning are just as vital as staying active By Julie Kailus for Aging at Altitude

or seniors, social wellness may be as important as physical wellness. Research backs this up. Having an active social life has been shown to decrease mental health issues and boost mood. There’s even research that

suggests that spending time with others can play a role in lowering your risk of dementia, improving cardiovascular function and living longer. And it’s crucial for quality of life. For many seniors, their adult children may have moved away. Some have lost their spouses. They may live alone. Without

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some sort of community or connection, they are entirely isolated. Loneliness can be all-encompassing. “At the Y, social connection inspires physical health and visa versa,” says Andra Coberly Webster, executive director of communications for the YMCA of Northern Colorado. When members

take regular classes or join programs, those classes become communities. “Members might come in for a Pilates reformer class, and then sit in the lobby for coffee and conversation,” she says. There are potlucks, coffee hours, fitness classes, knitting groups, ping pong clubs and more waiting at the YMCA.

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LIFELONG LEARNING In our rapidly evolving world, lifelong learning is not just a buzzword; it’s a necessity. And many older adults have found their knowledge hub at the Boulder JCC’s new Exchange program. “Since COVID, there’s been a gap for in-person lifelong learning for adults 55+ in Boulder County. Exchange fills that need,” says Joy Alice Eisenhauer, director of arts, culture and education for Boulder JCC. “We want adults to connect and forge new friendships. We’re committed to building opportunities for building community, connection and joy. And Exchange is just one example of that.” Exchange offers a diverse range of courses, workshops and seminars, spanning from history and technology to art and wellness. The program’s flexibility allows participants

to explore their passions and curiosities at their own pace, fostering a sense of empowerment and selfdiscovery. But Exchange is not just about acquiring knowledge; it’s also a gateway to meaningful social connections. Participants engage in vibrant discussions and build lasting friendships. “These connections not only combat social isolation but also provide a platform for exchanging wisdom and experiences, enriching the lives of all involved,” says Eisenhauer. CULTIVATING COMMUNITY For older adults who need more assistance connecting with the community, there’s Cultivate. Cultivate has over 50 years of experience helping seniors flourish through active engagement with their communities.

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Cultivate volunteers help with no-cost rides to medical appointments; grocery shopping and delivery; minor home repairs; friendly checkin calls; snow shoveling and yard cleanup; and so much more. “Each of these services allows people to age in place and retain their independence,” says Director of Volunteers Carly Marquis. “But beyond the direct services, Cultivate volunteers provide something even more transformational — a reprieve from isolation. Both clients and volunteers benefit from the socialization with one another, and family members enjoy peace of mind knowing that their loved ones are receiving

much-needed services from caring members of the community.” GIVING BACK For older adults who want to give back, Intercambio Uniting Communities is making that a reality. Founded on a philosophy of mutual learning and dedicated to fostering a sense of belonging, since 2001 the program has trained thousands of volunteers to teach English to adult language learners in-person or online. Most Intercambio instructors have no prior teaching experience and over 65% are 55+, making the program an instant community for older adults. “Volunteers contribute their life experience,

There are potlucks, coffee hours, fitness classes, knitting groups, ping pong clubs and more waiting at the Y. (Photo: YMCA of Northern Colorado).

patience, empathy and a sincere desire to connect with people from diverse backgrounds,” says Director of Curriculum and Training Leanne Chacon. “Volunteer

teachers feel more connected to their communities, and learners feel more welcome, reducing feelings of isolation and promoting increased well-being for all.”

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Improving the Quality of Life Boulder County seniors have a myriad of resources to enrich their lives services, as well as in the Eat Well Café in Boulder, where residents can find affordable meals even as they make important social connections.

TRU PACE offers residents and enrollees a sense of community and connection, integrating peers and family members alike.(Photo: TRU Pace)

By Adam Goldstein for Aging at Altitude

n Boulder County, seniors have myriad resources at their disposal to enrich their lives. Those resources go far beyond the corner pharmacy. From services that specialize in vision to organizations dedicated to nutrition and even proper stretching, seniors in Boulder have easy access to programs that directly improve their quality of life. That includes healthcare at every level. Here’s a quick guide to some of the most valuable

resources for seniors in Boulder County, services that can make a profound difference. MEALS ON WHEELS Since 1969, Meals on Wheels Boulder (mowboulder.org) has offered a compassionate and caring solution to seniors who need assistance when it comes to nutrition. Whether it’s providing food to those who can’t afford it, helping those with limited capacity with the simple act of grocery shopping or simply providing sorely needed companionship and human contact, Meals on Wheels

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has long offered critical services that many take for granted. “We’ve been bringing health and humanity to the table for more than 50 years. We bring hot and nutritious meals to Boulder neighbors in need,” said Shoshana Fanizza, manager for Meals on Wheels Boulder. “We also provide much-needed social interaction. The population we’re talking about may not have any interactions with people aside from delivery drivers.” That critical social component comes in the organization’s basic

TRU PACE That commitment to connection also drives the mission at TRU PACE (Program of All-inclusive Care for the Elderly), a unique facility located in Lafayette (pace.trucare.org). In addition to comprehensive medical care, TRU PACE offers residents and enrollees a sense of community and connection, integrating peers and family members alike. “Caring for vulnerable seniors is at the heart of TRU PACE’s mission. We are a team, creating a safe, nurturing medical home so that our participants can actively engage in their own healthcare while engaging with other seniors,” said Staci Baker, TRU PACE spokeswoman. “This social model works, improving quality of life and keeping them away from hospitals and nursing homes more than if they did not have us. “It is a model of care that more communities should strive to deliver,” she added. STRETCHLAB Maintaining connections sometimes means maintaining physical

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of certified Flexologists customize stretch programs to suit everyone’s unique needs and goals,” said owner Trey Schott. “The benefits of a customized assisted stretching program as a part of your weekly routine can include increased mobility and range of motion, enhanced flexibility, improved posture, decreased pain, reduced chance of injury, reduced stress, increased strength and neuromuscular coordination and improved circulation.”

Maintaining connections sometimes means maintaining physical strength.(Photo: StretchLab)

strength, and StretchLab Boulder (stretchlab.com) is dedicated to keeping its patients active, healthy and physically fit. StretchLab’s unique approach to wellness

incorporates professionals who work with patients to find an individualized routine that keeps patients limber, flexible and whole. “At StretchLab, our team

AUDIO INFORMATION NETWORK OF COLORADO / AFTERSIGHT The Audio Information Network of Colorado (aincolorado.org), which is

in the process of adopting the new brand of Aftersight, fulfills a unique mission for blind, low-vision individuals, as well as those who need an alternative to print media across Boulder County and Colorado. Aftersight’s resources include audio recordings of all types of print media, including newspapers, magazines and other texts in both English and Spanish. The organization distributes these tools via a broad network of programming, including free podcasts, radio broadcasts, streaming services and digital downloads. Their dedication isn’t limited to media. Aftersight has worked to partner directly with Boulder County’s population in

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many impactful ways, including offering free white canes, organizing virtual peer support groups and establishing an audio book club. Like Meals on Wheels, Aftersight’s commitment goes beyond its resources – it also includes providing individuals with a social network. “Our purpose is to offer connection,” Aftersight officials explain on their website. “We connect people with voices that understand and heal, with tools that Whether it’s providing food to those who can’t afford it, helping those with limited capacity with the simple act of offer self-sufficiency, with grocery shopping or simply providing sorely needed companionship and human contact, Meals on Wheels has long offered critical services that many take for granted. (Photo: Meals on Wheels Boulder). news that informs and educates, with events that the epicenter in the has been at the forefront of looking for a solution to empower and with stories reimagining of cannabis, that shift, and their menu aches and pains, or for a that entertain.” specifically when it comes includes a vast array of way to boost your mood, to incorporating medicinal blends and buds designed the budtenders at Starbuds STARBUDS treatments for patients of all to address specific medical have the perfect blend for Colorado has been your needs. needs. Star Buds (starbuds.us) needs. Whether you’re

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n an era characterized by technological advancements and digital connectivity, individuals age 50 and above are increasingly turning to online resources to foster social connections and engage in enriching activities. One remarkable trend among this demographic is the rising popularity of online book clubs. These virtual literary gatherings provide a platform for seniors to come together, discuss literature, and build meaningful connections without leaving the comfort of their homes. The digital age has ushered in a plethora of opportunities for seniors to explore their interests and passions. SeniorPlanet.org, a trusted resource for older adults, recognizes the significance of online book clubs and has dedicated a space to guide seniors in finding their perfect literary community. The website offers valuable insights into the benefits of joining such clubs, emphasizing the positive impact on mental stimulation and social well-being. For those eager to dive into the world of virtual book clubs, BookClubs.com provides a comprehensive directory of book clubs to join. This user-friendly platform allows individuals to search for clubs based on their preferences, such as genre, location or meeting frequency. With an easy

signup process, seniors can connect with like-minded readers and participate in thought-provoking discussions that transcend geographical boundaries. One particularly innovative approach to online book clubs is the use of Virtual Reality (VR) technology. Thrive Pavilion, an organization dedicated to promoting active aging through technology, has harnessed the power of VR to create immersive book club experiences for seniors. Through VR chat sessions, participants can engage in lively discussions as if they were sitting in the same room. This novel approach not only enhances the sense of community but also adds a new layer of excitement to the reading experience. In Colorado, seniors have an abundance of options to choose from when it comes to online book clubs. Area residents can tap into the rich literary scene offered by dailybookclubs.com. The website provides a local touch by connecting with book clubs that cater to their specific interests and preferences. It’s a fantastic way for seniors to stay engaged and interact with fellow book lovers. The Colorado Virtual Library is another valuable resource for seniors seeking book club communities. This platform fosters resourcesharing and collaboration among various book clubs in the state. You’ll find a book club that suits your literary

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Through VR chat sessions, participants can engage in lively discussions as if they were sitting in the same room.

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tastes and schedule. The Denver Public Library is also a hub for book club enthusiasts. DCL.org offers a variety of book clubs that cater to different age groups and interests, including those tailored specifically for seniors. By joining these clubs, older adults can enjoy the benefits of reading, socializing, and sharing their thoughts on literature in a welcoming and inclusive environment. The rise of online book clubs has brought about a transformative shift in the way people engage with literature and connect with one another. The resources provided by SeniorPlanet.org, BookClubs.com,

Thrive Pavilion and the thriving book club scene in Colorado are proof of the growing interest in this digital literary movement. Seniors are finding solace, companionship, and intellectual stimulation in the pages of books and the discussions that follow. Whether they prefer traditional online book clubs, VR-enhanced experiences, or local gatherings, older adults are embracing these digital avenues to enrich their lives and foster meaningful connections. In doing so, they are demonstrating that age is no barrier to exploring new horizons and experiencing the joy of literature.

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